Provider Demographics
NPI:1225199821
Name:FUGITT, DENNIE LEE (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DENNIE
Middle Name:LEE
Last Name:FUGITT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2784 MILKY WAY
Mailing Address - Street 2:NORTH COUNTRY ANESTHESIA
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-9538
Mailing Address - Country:US
Mailing Address - Phone:509-935-6225
Mailing Address - Fax:509-935-6207
Practice Address - Street 1:2784 MILKY WAY
Practice Address - Street 2:NORTH COUNTRY ANESTHESIA
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-9538
Practice Address - Country:US
Practice Address - Phone:509-935-6225
Practice Address - Fax:509-935-6207
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006369367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered